President-elect Trump has promised to repeal the Affordable Care Act (ACA), often known as “Obamacare.” However, he and the Republican leaders in Congress have not yet made clear whether some provisions of the ACA will survive and, what, if anything, would replace the ACA. The ACA provision which has been most helpful to persons with mental illnesses in Illinois is the one which allowed Illinois to substantially expand its Medicaid program.
Under the ACA, states are allowed to chose whether to expand coverage of their Medicaid program. Historically Medicaid has been available only to persons whose income is at or below 100% of the Federal poverty level. The Medicaid expansion provisions of the ACA allow persons making up to 138% of the poverty level to be covered. Importantly, the Federal government covers between 90 and 100% of the cost of care for persons in the Medicaid expansion program. For persons in the “traditional” Medicaid population the Federal share is typically only 50%. Thus, Illinois and the 30 other states which have thus far elected to expand Medicaid are able to provide health care to more than 11 million new people at little or no cost to state taxpayers. In Illinois, more than 650,000 people are now covered by Medicaid due to the expansion provisions of the ACA. In the 18-month period between January 2014 and June 2015, the Federal government paid $3.3 billion for health care for persons in the Medicaid expansion population in Illinois. Illinois paid only $52 million as its share–less than 2%. This data is from “What Coverage and Financing is at Risk Under a Repeal of the ACA Medicaid Expansion?” The Kaiser Commission on Medicaid and the Uninsured (December, 2016)
Illinois is already in very bad fiscal shape. If President-elect Trump and the United State Congress eliminate the Medicaid expansion program, it is extremely unlikely that Illinois would be able to find additional billions of dollars to cover health care costs for more than 650,000 Medicaid expansion enrollees. Many of these people have serious mental illnesses. They will no longer be able to get treatment for their mental illness or any other health care condition. This will harm them and their families and communities.
Action item: Tell your United States Senator and Congressperson not to repeal the Medicaid expansion provisions in the ACA.
Letter to Governor Rauner concerning the possible repeal of the ACA: protect-medicaid-aca-governor-rauner-letter_final_12-15-2016